It’s the morning after the Democratic National Convention
and my head is reeling at the extreme importance of the upcoming U.S. election.
I believe I am uniquely qualified to comment on this issue:
·
I have both an MD (with two specialties in
chronic illness) and a PhD in medical research (specializing in population
studies, statistics and health economics)
·
I trained in medicine in both the U.S. and Canada
·
I have worked as a doctor in both the U.S. and
Canada
·
I have lived roughly half my life in each
country, including at least a decade in each country as an adult
·
My specialty has been patients with chronic pain,
especially fibromyalgia, for which I am considered a world expert in research
·
I also have worked with migrant Mexican farm
workers in California
·
I worked as a physician in California during the
1980s AIDS epidemic
·
I have followed U.S. politics since I was 18
·
I actually care about people
And so it is that I watched the Republican and Democratic
national conventions every evening they were on TV, with great interest. And
again, my head is now reeling.
On one hand, you have Obama and Biden, who are actively
moving the U.S. system towards universal health care in a way that will, in
some ways, mimic what Canada has had since Saskatchewan Premier Tommy Douglas
first introduced ‘universal health care’ in 1946. On the other hand, you have Romney and Ryan
wanting to return to the minimal coverage system the U.S. had had for decades,
until Obama was elected and moved to change it.
Over the next series of blogs, I want to comment upon the
differences in the visions of these two men. But let me start by comparing the
current Canadian and old American system.
I’ve often said that the Canadian health care system is equally bad for
everybody. I say this because waiting lists
can be and often are very long... sometimes months even for cancer surgery, or
up to 18 months for back surgery. There
is an almost universal shortage of physicians. In London Ontario, where I now
live, a recent estimate was that roughly 10% of its 350,000 residents had no
family doctor. They must rely on various
urgent care clinics and emergency rooms, which will provide some but not all
services (for example, you usually need a family doctor to fill out a disability
form for you). So again, the system often is not nearly as good as it should
be... but it is equally bad for everyone.
With the old U.S. system, you can almost have some hot-shot
surgeon cut off your nose, turn it upside down and sew it back on... and you
can have all this done yesterday and eat steak for dinner that night... but
here’s the rub... IF you have the right insurance. But it you don’t... as my
father would say... tough beans! While I
was in California working at a northern California clinic that provided health
care to migrant Mexican farm workers, back in the 1980s, I heard of a young,
pregnant Hispanic woman who bled to death in a taxi, traveling between emergency
rooms because she didn’t have the necessary insurance for the first hospital to
treat her. Her unborn baby died too. I also remember that time, I believe back
in the early nineties, when thousands of pregnant Floridians (women, obviously)
flocked into Georgia to get their pre-natal health care, because Florida
doctors refused to see them. The old American system, then, can be great for
some, but virtually non-existent for others.
From what I’ve read about Obama’s plan, he is not proposing
the Canadian system. What he is proposing is access to health care for
everyone, irrespective of who they are and whatever insurance they have. Many,
many Canadians carry private insurance too, to cover things (like medications)
that the universal health care system does not cover.
I won’t be shy about it... I am staunchly in favour of Obama’s
versus Romney’s plan. Is Obama’s plan
the best plan ever? I don’t know and hence won’t comment. But it is vastly
better than the minimalist system Romney and Ryan want.
I will start from an economic standpoint, because so many critics
will rebuke me by saying that the U.S. can’t afford universal health care. The truth is that universal health care will almost
certainly cost the system less. In Canada, for example, the cost of most
laboratory or imaging tests is anywhere from 5 to 10 times less than the cost
of an identical test in the U.S. Those Canadian
snowbirds (that’s what usually elderly Canadians who flock to the southern U.S.
in winter are called) who are unfortunate enough to become ill or injured while
south of the border find out if they don’t have good traveller’s insurance. I once had a patient who went into an
emergency room in Florida to have a routine blood test done, to monitor his
diabetes, only to receive a bill for thousands of dollars afterwards. He was
charged not only for the test itself, but a consultation fee to pay the doctor
who interpreted the test, and the doctor who briefly saw him in the emergency
room to order the test. In Canada, that test would have cost him zero. And what
would the cost to an American travelling in Canada be under the same
scenario... likely less than $50. The
fact is that U.S. hospitals often charge exorbitant fees for tests, knowing
that insurance companies only will agree to pay a fraction of it. Someone who
doesn’t have insurance doesn’t have that leverage, so they are charged the full
amount. That’s why medical care in the U.S. can be so damn high.
Providing structured universal health care for everyone will
give everyone that leverage, keeping costs lower.
But won’t the government be paying those costs? Sure. But remember
that they will be able to negotiate much lower rates. Besides, here’s what they
won’t have to pay... they won’t have to pay for all those sick and disability
days people who are untreated or inadequately treated will have to suffer
through. And people who don’t lose
everything paying unreasonable medical bills will be able to pay their taxes,
instead of declaring bankruptcy. AND
they’ll be more likely to spend money at stores and local businesses to
stimulate the local economy. And I could go on.
But I want to get back to why I really prefer Obama’s
plan. It goes back to the reason I went
into medicine in the first place... it’s because I care. The word ‘care’ is, after all, within the
term ‘health care’.
What I care about is fairness for all people, irrespective
of who they are. Again, the Canadian system is flawed but, at least in theory,
it is no more flawed for the single mother of two than it is for the Prime
Minister himself. Pregnant women should never die in taxis in Canada because
they don’t have health insurance.
Compassion and care for the sick is not compassion and care for the
wealthy sick or the insured sick. It’s compassion and care for everyone.
In the next blog, let me talk about why this is particularly
critical for those with fibromyalgia.
Kevin White, MD, PhD
Award-winning author, researcher & speaker
Visit my website to vote on which president
YOU think would be better for the person with fibromyalgia or chronic pain –
Obama or Romney
